Adding ADHD drug to therapy improves cognitive outcomes in TBI patients

  • A preliminary study suggests adults with persistent difficulties after TBI may benefit from a metacognitive training program in conjunction with use of Ritalin.

A small study involving 71 adults who struggled with persistent cognitive difficulties after suffering a traumatic brain injury at least four months before has compared two cognitive training programs with and without drug therapy.

The two six-week programs were

  • Memory and Attention Adaptation Training program, a brief cognitive-behavioral therapy aimed at enhancing skills for self-managing and coping with cognitive failures in daily life. It includes four components:
    • education regarding ‘normal’ cognitive failures, as well as potential effects of TBI on cognitive function
    • self-awareness training to identify ‘at-risk’ situations where cognitive failures are likely to occur
    • self-regulation training emphasizing applied relaxation techniques and stress management
    • cognitive compensatory strategy training
  • Attention Builders Training, involving
    • repetitive cognitive tasks to build skills through ‘mental exercise’
    • an educational component discussing common cognitive symptoms after TBI

Participants of both groups also received either the drug methylphenidate (Ritalin) or a placebo.

The best improvement (still modest) was noted in those who received methylphenidate along with the Memory and Attention Adaptation Training. They were better able to learn lists of words, while their working memory and their attention improved.

Do note, however, that these findings must be considered preliminary, due to the relatively small number of participants in the each group (17-19 people).

https://www.eurekalert.org/pub_releases/2016-11/s-hfp112216.php

https://www.eurekalert.org/pub_releases/2016-11/iu-aad112216.php

Paper available at https://www.nature.com/articles/npp2016261

Reference: 

McDonald, B.C. et al. 2016. Methylphenidate and Memory and Attention Adaptation Training for Persistent Cognitive Symptoms after Traumatic Brain Injury: A Randomized, Placebo-Controlled Trial, Neuropsychopharmacology. doi: 10.1038/npp.2016.261